RANDOLPH CLARK (NPI# 1568456036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568456036 |
| Entity Type | Individual |
| Full Name | RANDOLPH CLARK |
| Credential | M.D. |
| Practice Address |
2510 W Dunlap Ave Ste 290 Phoenix AZ 85021-2759 |
| Practice Telephone | 6027890344 |
| Practice Fax Number | 6027898389 |
| Mailing Telephone | (602) 789-0344 |
| Mailing Fax Number | 6027898389 |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2017-05-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 27792 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 648751 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245665363 | Randolph Laird Clark | Social Worker | 6655 E Us Highway 36, Avon, IN 46123-8923 | 2013-09-09 |
| 1649347097 | Randolph Lynn Clark | Dentist | 301 S Boulevard St, Suite 118, Edmond, OK 73034-3878 | 2006-11-29 |
| Street Address |
2510 W DUNLAP AVE STE 290 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85021-2759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285044677 | Ashleigh Welko | Pediatrics | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2014-05-06 |
| 1093090631 | Rahul Raman | Pediatrics | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2011-10-14 |
| 1093009672 | Jason Scott Couch | Pediatrics | 2510 W Dunlap Ave Ste 290, Suite # 290, Phoenix, AZ 85021-2759 | 2011-06-01 |
| 1790009660 | Cynthia M Armstrong | Nurse Practitioner | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2010-03-22 |
| 1346473782 | Gary Robert Hensley | Internal Medicine | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2009-09-02 |
| 1588828032 | Sarah Shb Bannister | Pediatrics | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2008-07-14 |
| 1821208190 | Alissa Renee Darden | Pediatrics | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2007-05-23 |
| 1164599528 | Judith Mary Beck | Family Medicine | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2006-11-29 |
| 1457371759 | Zafar Abdul Quadir | Pediatrics | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2006-07-20 |
| 1669418331 | Sanjay Patel | Family Medicine | 2510 W Dunlap Ave Ste 290, Phoenix, AZ 85021-2759 | 2006-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173181 | Jill M Robinson | Social Worker | 8804 N. 23rd Ave, Bldg. A Ste. A01-a02, Phoenix, AZ 85021 | 2020-10-26 |
| 1528671013 | Sabrina Mcninch | Behavior Technician | 1200 W Dunlap Ave, Ste 100, Phoenix, AZ 85021 | 2020-08-25 |
| 1376169938 | Maricopa County Special Heallth Care District | Pharmacy | 2025 W Northern Ave, Phoenix, AZ 85021 | 2020-06-19 |
| 1841832664 | Madison Westby | Physical Therapist | 717 W Dunlap Ave # 100, Phoenix, AZ 85021 | 2019-10-14 |
| 1861967481 | Southwest Family Naturopathic Clinic Pllc | Naturopath | 1530 W Glendale Ave Suite 103, Phoenix, AZ 85021 | 2018-10-10 |
| 1184101461 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 8804 N 23rd Ave, Suite A01/a02, Phoenix, AZ 85021 | 2018-07-19 |
| 1568970150 | Alycia Ann Poloni | Occupational Therapist | 7129 N 23d Ave, Phoenix, AZ 85021 | 2018-01-17 |
| 1154839165 | Cyrus Professional Corporation | Dentist | 2401 W. Glendale Ave, Ste 102, Phoenix, AZ 85021 | 2018-01-12 |
| 1568980779 | Marla Jean Clay | Licensed Practical Nurse | 1717 W. Glendale Ave. Apt. 3011, Phoenix, AZ 85021 | 2017-09-07 |
| 1801325162 | Kaitlin King | Nurse Practitioner | 8824 N 9th Ave, Phoenix, AZ 85021 | 2017-06-08 |
| Find all providers in zip 85021 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902415011 | Aims-az-med, LLC | Internal Medicine | 1346 E Mcdowell Rd, Phoenix, AZ 85006-2616 | 2020-07-24 |
| 1245865096 | Cleanslate Medical Group of Arizona Pllc | Internal Medicine | 8410 W Thomas Rd Ste 124, Phoenix, AZ 85037-3373 | 2020-03-11 |
| 1114576162 | Caring Doctor LLC | Internal Medicine | 27412 N 58th Ln, Phoenix, AZ 85083-7394 | 2019-09-11 |
| 1417500034 | Contrast Medical Pllc | Internal Medicine | 813 E Fairmount Ave, Phoenix, AZ 85014-4708 | 2019-07-23 |
| 1386106045 | Key Medical Solutions LLC | Internal Medicine | 1120 E Waltann Ln, Phoenix, AZ 85022-3531 | 2019-04-02 |
| 1700350261 | Nierenberg Associates,pa | Internal Medicine | 1800 E Van Buren St # 605, Phoenix, AZ 85006-3742 | 2019-01-17 |
| 1952875783 | Vpa PC | Internal Medicine | 7600 N 15th St Ste 165b, Phoenix, AZ 85020-4305 | 2019-01-15 |
| 1568944148 | Avicenna Integrative Medicine Plc | Internal Medicine | 4429 N 44th St, Phoenix, AZ 85018 | 2018-08-30 |
| 1053803676 | Ahwatukee Health Care, LLC | Internal Medicine | 16515 S 40th St Ste 119, Phoenix, AZ 85048-0559 | 2018-05-30 |
| 1720590011 | Dr Richards Pllc | Internal Medicine | 20815 N 25th Pl Ste A106, Phoenix, AZ 85050 | 2017-10-26 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.